Pituitary apoplexy is acute neural endocrine disease due to suddenly hemorrhage, infarction, necrosis, swelling in pituitary tumor.
The incidence of pituitary apoplexy is about 0.6% ~ 10% for pituitary adenomas. Male patients than female and incidence ratio of male and female is about 2:1. The highest incidence of intracranial hemorrhage is hemorrhage in pituitary adenoma, since hemorrhage in intracranial tumors, 50% of gliomas, 25% of pituitary adenoma, pituitary adenoma and intracranial tumors account for only about 9.5%. Pituitary apoplexy usually occur in large pituitary adenoma and less in pituitary micro adenomas.
Pituitary apoplexy mainly shows severe symptoms of meningeal irritation due to bleeding, and symptoms of oppression surrounding tissue. According to the tumor on the surrounding tissue and the severity of illness, pituitary apoplexy can divided into four types:
1. Explosive pituitary apoplexy (Ⅰ type): that is the rapid bleeding, massive bleeding, directly affecting the hypothalamus, when patients are significantly associated with cerebral edema and intracranial hypertension, three hours after bleeding, occur apparent vision disorder, consciousness obstacles to increase of up to coma or even death.
2. Acute pituitary apoplexy (Ⅱ type): that is relatively rapid bleeding, relatively large amount of bleeding, has been involved surrounding tissue, but not under the influence of the hypothalamus, also no significant brain edema and intracranial hypertension, clinical manifestations include headache, visual barriers, eye muscle paralysis or disturbance of consciousness.
3. Subacute pituitary apoplexy (Ⅲ type): that is slow bleeding, visual impairment or ophthalmoplegia, the original increase of pituitary adenoma with mild symptoms and no meningeal irritation and disturbance of consciousness, patients are often overlooked.
4. Chronic pituitary apoplexy (Ⅳ type): that is less bleeding, no pressure of surrounding tissue, in addition to the original clinical manifestations of pituitary adenoma, no other symptoms, is often found when the CT, MRI or surgery.